Organization Active NPI

Dale L. McGregor, D.O., P.C.

  • Skilled Nursing Facility
  • Moultrie, GA
National Provider Identifier
1235339714
Registry record updated Dec 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
025220 Issued in GA
Legal business name
DALE L. MCGREGOR, D.O., P.C.
Practice address
102 Cobblestone Trce SE
Moultrie, GA 31788-7748
Phone
(229) 985-3400
NPI assigned
Jul 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Dale Lee McGregor, D.O.
Title
Physician/President
Phone
(229) 985-3400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 025220 GA Primary

Addresses

Primary practice location

102 Cobblestone Trce SE
Moultrie, GA 31788-7748

Mailing address

102 Cobblestone Trce SE
Moultrie, GA 31788-7748
Phone (229) 985-3400

Other identifiers 1

IdentifierTypeStateIssuer
000268815AMedicaidGA

National Provider Directory

National Provider Directory

Locations

102 Cobblestone Trce SE
Moultrie, GA 31788
Phone (229) 985-3400

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418947200000",
    "number": "1235339714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 COBBLESTONE TRCE SE",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317887748",
            "telephone_number": "229-985-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 COBBLESTONE TRCE SE",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317887748",
            "telephone_number": "229-985-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALE L. MCGREGOR, D.O., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-23",
        "last_updated": "2014-12-19",
        "status": "A",
        "authorized_official_last_name": "MCGREGOR",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PHYSICIAN/PRESIDENT",
        "authorized_official_telephone_number": "229-985-3400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "025220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000268815A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moultrie, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.